Acute Heart Failure in Coronavirus Disease 2019 and the Management of Comedications

A Multiparametric Approach', which comprehensively summarises the clinical characteristics of cardiovascular complications associated with coronavirus disease 2019 (COVID-19) and the use of telehealth in patients with heart failure. 1 This review should be highly valued considering that the rather high prevalence of cardiovascular comorbidities, including heart failure, among patients with COVID-19 is now recognised. Individuals with underlying cardiovascular conditions are at increased risk of myocardial injury associated with COVID-19, as reported previously, possibly due to reduced cardiorespiratory reserves. 2 We would like to complement the discussion of Oliveros et al. on acute heart failure and the use of renin-angiotensin system (RAS) inhibitors. 1 Acute heart failure represents a common cardiovascular complication of COVID-19, which may be precipitated by acute illness in patients with pre-existing known or undiagnosed heart disease or incident acute myocardial injury. Although Oliveros et al. are correct to suggest that routine antihypertensive therapy including RAS inhibitors should not be altered in the context of COVID-19 by citing recommendations from several professional cardiology societies, extreme caution should be taken in COVID-19 patients who develop acute heart failure. 1